Whole-population trends in obesity across dimensions of inequality in England, 2019–25: a retrospective, longitudinal cohort study of 54 million adults
Authors' conclusion
Obesity affects nearly one in three adults in England, with disproportionate burden among disadvantaged groups and widening disparities since the COVID-19 pandemic.
Study context
- Population
- Entire population of adults aged 18–99 years in England with records in the NHS England Secure Data Environment, Nov 1, 2019 to April 30, 2025
- Participants
- 54,892,390 participants
- Outcome
- Incidence and prevalence of obesity (BMI ≥30.0 kg/m² or clinician-assigned diagnosis), by age, sex, socioeconomic status, ethnicity and region
- Follow-up
- 2019 to 2025
Methodological detailswhole-population, individual-level anonymised electronic health records, age- and sex-standardised rates, negative binomial regression
- Whole-population
- Individual-level anonymised electronic health records
- Age- and sex-standardised rates
- Negative binomial regression
Main finding
As reported in the abstract
2019–2025
- Age- and sex-standardised incidence of first-recorded obesity, per 1000 person-years
- 22 (95% CI 22-22)
- Change in incidence, IRR 2024-2025 vs 2019-2020
- 1.04 (95% CI 1.01-1.07)
- Obesity prevalence by 2025
- 30.3%
- Obesity prevalence at start of study
- 26.3%
- People with first presentation of obesity
- 4 131 555
Observational data: associations, not effects.
Further findings
| Outcome | IRR (95% CI) | |
|---|---|---|
| Obesity incidence, most vs least socioeconomically deprived quintileMost deprived quintilevs Least deprived quintile | 1.35 (1.28–1.42) | |
| Obesity incidence, most vs least socioeconomically deprived quintileMost deprived quintile, womenvs Least deprived quintile, women | 1.54 (1.45–1.64) | |
| Obesity incidence, most vs least socioeconomically deprived quintileMost deprived quintile, Asian womenvs Least deprived quintile, Asian women | 1.94 (1.86–2.02) | |
| 0.512Incidence rate ratio (log scale) |
Trend in obesity incidence by age · over study period
- Aged 20-29 years, IRR
- 1.16 (95% CI 1.08-1.25)
- Aged 30-39 years, IRR
- 1.19 (95% CI 1.13-1.25)
Obesity prevalence by subgroup
- Least deprived White men aged 18-19 years
- 4.3%
- Most deprived Black women aged 60-69 years
- 66.1%
- Least-deprived White women aged 60-69 years
- 34.5%
Geographical obesity prevalence
- Prevalence range across areas
- 8.5% and 48.1%
- Largest increases over time in most deprived regions
Characteristics at first presentation of obesity
- Women
- 2 278 485 (55.1%)
- Men
- 1 853 070 (44.9%)
- White
- 3 106 740 (75.2%)
- Asian or Asian British
- 482 690 (11.7%)
- Black, Black British, Caribbean, or African
- 291 920 (7.1%)
- Median age, years (IQR 31-58)
- 43
- Mean BMI, kg/m² (SD 10.7)
- 33.4
Original publication
Whole-population trends in obesity across dimensions of inequality in England, 2019–25: a retrospective, longitudinal cohort study of 54 million adults. Lancet Diabetes Endocrinol. Published 24 June 2026. doi:10.
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